Congenital Heart Disease 1

7/21/2019 Congenital Heart Disease 1

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CHD definition

Congenital heart disease may be defined asabnormality in cardiocirculatory structure orfunction that is present at birth.

CONGENITAL HEART DISEASE

• The approach to congenital heart disease• Incidence, aetiology, environmental and assoc

syndromes, recurrence risks – Classification

– Features common to different classes – Individual types of chd in each class

• Changes in development causing defects• Pathophysiology and clinical consequences• Management – history, examination, investigations, treatment

medical and surgical.

Incidence of CHD

8-10/1000 of live births20/1000 of still births

20/1000 of preterms Excludes

Bicuspid Aortic valves 9/1000 live births.Transient PDA of pretermMVP.



Congenital heart disease

Classificationcyanoticacyanotic

Cxray pulmonary vascularityincreased/normal/decreased

ECG left ventricular hypertrophyright ventricular hypertrophy

bi-vertricular hypertrophy

Aetiology

• Multifactorial 87%• Environmental 3%• Genetic 10% (chr 3 gen 7) Multifactorial - genetic predisposition caused

by several genes causes susceptiblility toenvironmental factors.

Enviromental factors

Disorder % Types

Rubella 50 PDA, Pul Br StenMat. diabetes 3-5 TGV, VSD, CoAMat. Phenylket 30 TOF, VSD, ASDThalidomide 15 TOF, TGV, DORVFoetal alcohol 35 VSD, ASD, TOF



Syndromes with CHD

Syndrome % with TypesCHD

Trisomy 21 50 AVdef, VSD,TOFTurner 30 Co Aorta

Noonan 65 PS, ASD, ASHTr 13 80 VSD, PDATr 18 90 VSD, PDAMarfan 60 MVP, AoA, AR

Recurrence risks CHD

Incidence in sibs about 3% (tripled)

Incidence if 2 sibs affected tripled again toabout 10%.

Frequency of types CHD

Ventricular septal defects 25-30%Atrial septal defects 6-8Patent ductus arteriosus 6-8Coarctation of Aorta 5-7Tetralogy of Fallot 5-7Pul valve stenosis 5-7

Aortic stenosis 5-7

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Congenital Heart Disease 1